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1144954488
ETHAN PHAM
TEMPE, AZ
NPI
1144954488
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363A00000X Physician Assistant
Additional Taxonomies
363AM0700X Physician Assistant, Medical
Enumeration Date
2022-07-12
Last Update Date
2023-12-08
Business Address
ETHAN PHAM
1030 E GUADALUPE RD
TEMPE, AZ 85283-3044
Phone number: 480-491-1898
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Mailing Address
ETHAN PHAM
2722 N 7TH ST UNIT 8
PHOENIX, AZ 85006-1067
Phone number: 714-908-6037
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